Optimizing HIV Prevention Among Opioid-Dependent Persons

优化阿片类药物依赖者的艾滋病毒预防

基本信息

批准号：
10652562
负责人：
MICHAEL COPENHAVER
金额：
$ 18.95万
依托单位：
UNIVERSITY OF CONNECTICUT STORRS
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-15 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10652562
关键词：
AIDS prevention Acquired Immunodeficiency Syndrome Address Adherence Adoption American Analgesics Applications Grants Behavior Therapy Behavioral Caring Characteristics Clinical Collaborations Communicable Diseases Communities Complement Disease Outbreaks Educational Status Evidence based intervention Face Funding Future Goals Grant HIV HIV Infections HIV risk Health Health Personnel Health Promotion Health behavior Impaired cognition Incubators Individual Injectable Injecting drug user Institution Interdisciplinary Study International Intervention Intervention Trial K-Series Research Career Programs Letters Malaysia Mentors Mentorship National Institute of Drug Abuse Needle-Exchange Programs Neurocognitive Deficit Ohio Opiate Addiction Opioid Patients Personal Satisfaction Persons Pharmaceutical Preparations Pharmacotherapy Policies Positioning Attribute Prevention Prevention strategy Process Public Health Research Research Personnel Risk Behaviors Risk Reduction Rural Science Scientist Series Structure Substance abuse problem Testing Time Training Uganda Ukraine United States National Institutes of Health Volatilization West Virginia Work access restrictions behavioral adherence biobehavior career clinical practice design evidence base experience global health high risk behavior high risk population implementation barriers implementation science improved mHealth meetings next generation opioid agonist therapy opioid epidemic opioid use disorder overdose death patient oriented patient oriented research pre-exposure prophylaxis prevent programs research data dissemination sex skills symposium therapy development treatment program trend

项目摘要

Abstract This revised K24 will enable me to optimize HIV prevention among opioid-dependent persons through three broad and interrelated aims that include: (1) Mentoring a greater number of new patient-oriented researchers via UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP) and the Yale AIDS Program, (2) Expanding my patient-oriented research (POR) program to include several high priority domestic (e.g., rural West Virginia/Ohio) and international settings (e.g., Uganda, Malaysia, and Ukraine), and (3) Engaging in structured training on critical issues surrounding the implementation of evidence-based HIV prevention within clinical settings nationally and internationally that will complement my POR skill set. The volatile opioid epidemic in the U.S. has taken an unimaginable toll, with 2.1 million Americans having an opioid use disorder (OUD) and overdose deaths reaching 70,200 in 2017 alone, representing over a 400% increase in 15 years.1 In parallel, a number of HIV outbreaks among people who inject drugs (PWID)2 reversed a downward trend in this group,1 reflecting the need to more effectively prevent HIV in this group, especially as patients with OUD transition from prescription pain killers to injectable opioids.3 Consequently, the CDC has intensified efforts to reduce the number of new HIV infections by more effectively and efficiently targeting PWID via: 1) reduced HIV risk behaviors, 2) increased adherence and retention in treatment; and 3) promotion of health behaviors that benefit individual and public health. Although drug- and sex-related HIV risk reduction and adherence are behaviors that are readily modifiable, interventions must be carefully designed and situated in a range of patient-oriented settings in the US and internationally.4-8 I am in the process of expanding my POR to focus on better identifying, understanding, and developing strategies at multiple levels to accommodate such patients so that they can derive optimal HIV prevention benefits via the next generation of interventions (e.g., mHealth).9 Such strategies will need to reinforce adherence to PrEP and other biomedical prevention (e.g., opioid agonist therapies [OAT] and syringe services programs [SSP]) alongside behavioral risk reduction. This will be especially important as priority domestic and international communities struggle with their inability to overcome policy factors that limit or restrict access to the full toolkit of HIV prevention (i.e., PrEP, OAT, SSP, behavioral interventions) for PWID. My ongoing (R01DA044867; Gilead ISR-US-19-10641), recently completed (R01DA032290; R01DA022122), and future HIV prevention projects form the basis of my POR and mentoring program as well as future domestic and international research collaborations. Each of the aims will provide a wide range of opportunities for expanding my POR and for my mentees to develop the skill set they need to become the next generation of HIV prevention scientists.

抽象的修订后的 K24 将使我能够通过三个广泛的和相互关联的目标包括：（1）通过康涅狄格大学的研究所指导更多以患者为导向的新研究人员健康、干预和政策合作 (InCHIP) 和耶鲁大学艾滋病项目，(2) 扩大我的以患者为导向的研究（POR）计划包括几个高度优先的国内（例如，西弗吉尼亚州/俄亥俄州农村）和国际环境（例如乌干达、马来西亚和乌克兰），以及 (3) 参与有关关键问题的结构化培训在国内和国际临床环境中实施基于证据的艾滋病毒预防，这将补充我的 POR 技能组合。美国不稳定的阿片类药物流行造成了难以想象的损失，有 210 万美国人患有这种疾病。仅 2017 年，阿片类药物使用障碍 (OUD) 和服药过量死亡人数就达到 70,200 人，15 年增加了 400% 以上 1 与此同时，注射吸毒者 (PWID)2 中的多起艾滋病毒疫情爆发扭转了这一数字的下降趋势。组，1 反映出需要更有效地预防该组中的艾滋病毒，特别是当 OUD 患者从处方止痛药改为注射阿片类药物。3 经过测试，疾病预防控制中心已加大力度减少新的数量通过以下方式更有效地针对吸毒者，减少艾滋病毒感染：1) 减少艾滋病毒危险行为，2) 提高依从性和坚持治疗；3) 促进有利于个人和公共健康的健康行为。与性相关的艾滋病毒风险降低和依从性是容易改变的行为，干预措施必须谨慎设计并位于美国和国际上一系列以患者为中心的环境中。4-8 我正在扩展我的 POR 专注于更好地识别、理解和制定多个层面的策略，以适应这种情况患者，以便他们能够通过下一代干预措施（例如移动医疗）获得最佳的艾滋病毒预防益处9。此类策略需要加强对 PrEP 和其他生物医学预防（例如阿片类激动剂疗法 [OAT]）的遵守和注射器服务计划 [SSP]）以及减少行为风险，这作为国内优先事项尤其重要。国际社会因无力克服限制或限制获得充分利用的政策因素而苦苦挣扎。针对注射吸毒者的艾滋病毒预防工具包（即 PrEP、OAT、SSP、行为干预）我正在进行（R01DA044867；吉利德） ISR-US-19-10641），最近完成（R01DA032290；R01DA022122），以及未来的艾滋病毒预防项目构成了基础我的 POR 和指导计划以及未来的国内和国际研究合作的每一个目标都将。提供广泛的机会来扩展我的 POR 并为我的学员提供发展他们所需的技能下一代艾滋病毒预防科学家。

项目成果

期刊论文数量（4）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

美沙酮维持治疗计划中高风险可卡因使用者自我报告的神经认知障碍的性别相关差异。

DOI：
发表时间：
2015
期刊：
影响因子：
0
作者：
Shrestha, Roman;Huedo;Copenhaver, Michael M
通讯作者：
Copenhaver, Michael M

Integrating Cognitive Dysfunction Accommodation Strategies Into Behavioral Interventions for Persons on Medication for Opioid Use Disorder.

将认知功能障碍调节策略纳入阿片类药物使用障碍患者的行为干预中。

DOI：
发表时间：
2022
期刊：
影响因子：
0
作者：
Mistler, Colleen B;Idiong, Christie I;Copenhaver, Michael M
通讯作者：
Copenhaver, Michael M

Factor structure, internal reliability and construct validity of the Methadone Maintenance Treatment Stigma Mechanisms Scale (MMT-SMS).

美沙酮维持治疗耻辱机制量表 (MMT-SMS) 的因素结构、内部信度和结构效度。

DOI：
发表时间：
2020
期刊：
影响因子：
0
作者：
Smith, Laramie R;Mittal, Maria Luisa;Wagner, Karla;Copenhaver, Michael M;Cunningham, Chinazo O;Earnshaw, Valerie A
通讯作者：
Earnshaw, Valerie A

Integrating Cognitive Dysfunction Accommodation Strategies into an HIV Prevention Session: A 2-Arm Pilot Feasibility Study.

将认知功能障碍调节策略纳入艾滋病毒预防课程：2 组试点可行性研究。